Affordable Care: Domestic partner coverage

“I am a municipal employee in Florida and for the past 2 years have had my partner be officially recognized as a “Domestic Partner” in the County. So we have been able to get health insurance though my policy, though we have to pay it after taxes. The question is this: does she have to report our household income to determine whether under the Health Care Act, she would qualify for a lower premium insurance plan? We pay a very high premium for her on a monthly basis.”

Miami Golden Girl

Dear Miami Golden Girl,

Domestic partners have lots of questions about health reform, and the enrollment forms do not mention them. In order to buy on the exchange, a person cannot have an employer plan offered to her. The question is whether your partner will be considered to have an employer plan available since she can join your plan at work. The Employer Coverage Tool form does not mention domestic partners, but only spouses and dependents. Since your partner is neither a spouse or a dependent, he/she can honestly state that employer-based coverage is not offered to her as a spouse.

When he/she goes to the marketplace, you might want to call and ask how to fill out the forms correctly.

There is another step to qualify to go to the marketplace: annual wages have to be less than 400% of Federal Poverty. For a single person, that would be $45,960. If she earns more than that, she would go “off exchange” and purchase an unsubsidized plan. You might want to find a health insurance broker to help you.

Her income alone will set her subsidy. Since you file taxes separately and are not legally married, your partner would apply for coverage using his/her own income. According to healthcare.gov’s description of how to report your income, you count income only from a spouse. The same page has some information about excluding your domestic partner from your count of household members if the partner does not need health insurance, but this is to calculate your percentage of Federal Poverty; not for calculating your household income.

It is possible that her coverage will cost less than your current group plan, paid for with after-tax dollars and not subsidized. It depends upon her income, and how generous or lean your current plan is compared to the exchange plan. Since you work for a municipality, your plan may be more generous than average. So it won’t be a big step up to get an exchange-qualified plan.